Provider Demographics
NPI:1851456644
Name:EHLERS, PETER (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:EHLERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23968 E HINSDALE PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5235
Mailing Address - Country:US
Mailing Address - Phone:877-844-3888
Mailing Address - Fax:303-690-7673
Practice Address - Street 1:23968 E HINSDALE PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5235
Practice Address - Country:US
Practice Address - Phone:877-844-3888
Practice Address - Fax:303-690-7673
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1986363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical